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DARAH
DEPARTEMEN FISIOLOGI
FK USU
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Tujuan
1. Mampu memahami fungsi dasar darah
2. Mampu mengenal komponen-komponen
darah dan fungsinya masing-masing
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Fungsi Darah
Distribusi
O2, CO2, nutrisi, hormon, waste product/sisa
metabolisme
Regulasi
Body temperature, pH
Proteksi
Melindungi tubuh dari kehilangan cairan
Melindungi tubuh dari infeksi
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DARAH
Merupakan jaringan tubuh
Volume 6 8 % BB
To
38o
C, pH 7,35
7,45 Terdiri dari plasma darah dan komponen
padat
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Components of Blood
LOOD=
55% plasma + 45% formed elements
is the liquid portion of the blood and
consists primarily of water (92 ) and
plasma proteins (7 )
Proteins - albumin, globulins, and
fibrinogen
FORMED
ELEMENTS
- solid component of the blood
consisting of erythrocytes,
leukocytes, and platelets
PLASMA
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PLASMA DARAH
90 % air
7 % protein : albumin, globulin, fibrinogen,
protrombin
3 % bahan organik : lipid, garam, nutrien,
waste product
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FUNGSI TIAP KOMPONEN
Air
Protrombin
Fibrinogen Albumin
Globulin
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When whole blood is spun
down in a centrifuge is
seperates into three distinct
components: plasma, white
blood cells combined with
the platelets, and the redblood cells.
About 55% of the bloodis plasma and about 45%
are cells( males generally havinga higher percentage of cells than females).
If the percentage of cells
becomes too low the person
is said to have anemia.
Hematocrit
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Blood Plasma/Plasma Darah
Blood is composed of cellular and non-cellular elements.
If the cellular components are removed: plasma remains.
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HEMATOCRIT
Perbandingan sel eritrosit terhadap volume
darah dalam bentuk persentase.
Pria : 42% - 54%
Wanita : 39% - 48%
Ht < = Anemia
Ht > = Polycytemia
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SEL-SEL DARAH
Sel darah merah (eritrosit)
fs : 99% mengangkut O2 dari paru keseluruh tubuh dan CO2 dari jaringantubuh ke paru.
Sel darah putih (leukosit)
fs : Melindungi tubuh dari infeksi dan
kanker Platelet (trombosit)
fs : Pembekuan darah
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ERITROSIT
Bentuk cakram, biconcave dengan bagian tepi
lebih tebal.diameter : 7m
Umur : 120 hari
Jumlah normal : 5. 106
/ mm3
Dibentuk di red bone marrow, dihancurkan/
dirombak di hati dan limpa
Eritropoeisis dipengaruhi oleh eritropoeitin.
Pembentukan eritosit juga dipengaruhi oleh vit B12,asam folat , ferum, testosteron
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Here is a picture of some blood - most all the cells you
see are erythrocytes - probably the easiest cell to identify
in all anatomy and physiology.
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Each RBC can contain up to 250 million
hemoglobin molecules!
Erythrocytes have a bi-concave disc shape - they look like donuts - their
shape optimizes their ability to carry oxygen
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Red blood cellsRegulation of Erythropoiesis
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Erythropoiesis= formation of
erythrocytes the body must produce about 2.5 million new RBCs
every second
in adults, erythropoiesisoccurs mainly in the marrowof the sternum, ribs, vertebral processes, and skull bones
begins with a cell called a hemocytoblast or stem cell(below)
rate is regulated by oxygen levels:
hypoxia (lower than normal oxygen levels) is detected bycells in the kidneys
kidney cells release the hormone erythropoietin into theblood
erythropoietin stimulates erythropoiesis by the bone
marrow
http://www.psbc.org/education/hematology/blood/made.htmhttp://www.psbc.org/education/hematology/blood/made.htmhttp://www.psbc.org/education/hematology/blood/made.htmhttp://www231.pair.com/grpulse/gp/medill/wblood.htmlhttp://www231.pair.com/grpulse/gp/medill/wblood.htmlhttp://www.psbc.org/education/hematology/blood/made.htmhttp://www.psbc.org/education/hematology/blood/made.htmhttp://www.psbc.org/education/hematology/blood/made.htmhttp://www.psbc.org/education/hematology/blood/made.htm -
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Red blood cellsHaemoglobin
Haemoglobin is a molecule specialised for transport of oxygen,
HAEM
composed of globin (made up of 4 highlyfolded polypeptide chains) + 4 heme groups
(with iron) each molecule can carry 4 molecules of
oxygen
called oxyhemoglobin when carrying oxygen &called reduced hemoglobin when not carryingoxygen
can also combine with carbon dioxide & helpstransport carbon dioxide from the tissues tothe lungs
http://www.chemistry.wustl.edu/EduDev/LabTutorials/Hemoglobin/MetalComplexinBlood.htmlhttp://www.chemistry.wustl.edu/EduDev/LabTutorials/Hemoglobin/MetalComplexinBlood.html -
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Each RBC can contain up to 250 million
hemoglobin molecules!
Jumlah Hb normal ; 12 14 g/dl (wanita), 13 16 g/dl (pria)
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SEL DARAH PUTIH (LEUKOSIT)
Mempunyai intiTerbagi atas : Agranular mononuklear
Granular polimorfonuklear
Jumlah Normal : 4.000 11.000/mm3
< 4.000 = Leukopenia
> 11.000 = Lekositosis
Leukopoiesis dipengaruhi oleh jenis dan banyaknya
jumlah mikoroorganismeyang masuk ke dalam tubuh
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Lymphocyte
Monocyte
Eosinophil
Basophil
Neutrophil
GranulocyteAgranulocyte
Leukocyte
White Blood Cells
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GRANULOCYTES
1. Neutrophils
40 - 75% of leukocytes
10 - 14um diameter
Exhibit multi - lobed nucleiCytoplasm lightly stippled with
indistinct granules
- represents large lysosomes
Active phagocytes that ingest
bacteria & cell fragmentsMulti - lobed
nucleus
CytoplasmErythrocyte
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1 - 6% of leukocytes
10 - 14um diameter
Bilobed nucleus
Abundant large ovoid granules
- stain bright red with eosin
Phagocytes that ingestantibody + antigen complexes
Release histaminase that
inhibits inflammation
GRANULOCYTES
2. Eosinophils Bi - lobednucleus
Cytoplasmic
granules
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< 1% of leukocytes
10 - 16um diameter
U- or S-shaped bi-lobednucleus
large blue cytoplasmic
granules
- exhibit basophilicstaining
Granules contain materials
that mediate inflammation
- eg. histamine
GRANULOCYTES
3. BasophilsBi - lobed
nucleus
Cytoplasmic
granules
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20 - 30% of leukocytes
6 - 9um diameter (small)
9 - 15um diameter (large - 3%)
Round, densely stained nuclei
Pale non-granular cytoplasm
Small lymphocytes have
relatively little cytoplasm
- attack pathogens & regulate
immune responses
Large lymphocytes make
antibodies
AGRANULOCYTES
1. Lymphocytes
Small
Large
Rounded
nuclei
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2 - 10% of leukocytes
14 - 24um diameter
Large, often indented, nuclei
Abundant grey-blue cytoplasm with
fine granules
Cytoplasmic vacuoles often evident
Highly motileDifferentiate into macrophages
which phagocytose
pathogens & dead tissue
AGRANULOCYTES
2. Monocytes
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TROMBOSIT (PLATELET)
Mempunyai inti
Umur 7 10 hari
Dibentuk oleh megakaryosit di sumsum tlg
Berperan pada proses pembekuan darah Jumlah normal : 150.103450.103
Bila < 150.103 = trombositopenia
> 450.103
= trombositosis
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Small cell fragments
Possess granules
2.5 to 5 x 105/mm3(250,000 -500.000
per cubic millimeter )
Produced by megakaryocytes in
marrow.
Regulated by thrombopoietin.
Contain granules.
Role in clotting
remain functional for about 7 - 10 days(after which they are removed from theblood by macrophages in the spleen &liver)
Platelets (orthrombocytes)
http://www.psbc.org/education/hematology/blood/platelets.htmhttp://www.psbc.org/education/hematology/blood/platelets.htm -
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HEMOSTASIS
Adalah penghentian perdarahan dari suatu
pembuluh darah yang rusak
Mekanisme hemostatik dalam keadaan normal
mampu menambal kebocoran dan menghentikanpengeluaran darah melalui kerusakan kecil di
kapiler, arteriol, dan venulamenjaga agar
kehilangan darah akibat trauma kecil tetap minimum
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Perdarahan dari pembuluh darah yang
berukuran sedang atau besar jarangterjadi biasanya tidak dapat dihentikan
oleh mekanisme hemostatik
Perdarahan pada arteri biasanya harus
dibantu dengan penekanan external
dengan kekuatan yang lebih besar dari
tekanan arteri itu sendiri kemudian
pembuluh darah yang robek ditutup secarabedah
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Perdarahan pada vena tidak selalu harus
ditangani dengan cara bedah karenasering kali dapat dihentikan hanya
denganmeninggikan bagian tubuh yang
berdarah untuk mengurangi efek gravitasi
pada tekanan di vena
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HEMOSTASIS
Melibatkan tiga langkah utama:
1. Spasme vaskuler
2. Pembentukan sumbat trombosit3. Koagulasi darah
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Hemostasis- prevention of blood loss from broken vessel 1 - Vascular spasm - vasoconstrictionofinjured vessel due to contraction of smooth
muscle in the wall of the vessel. This'spasm' may reduce blood flow & blood lossbut will not stop blood loss.
2 - Formation of a platelet plug- plateletsaggregate at the point where a vesselruptures. This occurs because platelets areexposed to collagen (a protein found in theconnective tissure located just outside theblood vessel). Upon exposure to collagen,platelets release ADP (adenosine
diphosphate) & thromboxane. Thesesubstances cause the surfaces of nearbyplatelets to become sticky and, as 'sticky'platelets accumulate, a 'plug' forms.
http://www.residentnet.com/private/vasc_res.htmhttp://www.platelet-research.org/htm/function_hemo.htmhttp://www.residentnet.com/private/coag2.htmhttp://www.residentnet.com/private/coag2.htmhttp://www.residentnet.com/private/coag2.htmhttp://www.platelet-research.org/htm/function_hemo.htmhttp://www.residentnet.com/private/vasc_res.htm -
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3 Blood coagulation (clotting)
The result of all of this is a clot-
formed primarily of fibrinthreads (or polymers), but also
including blood cells &
platelets.
Blood clots in the right places
prevent the loss of blood from
ruptured vessels, but in the
wrong place can cause
problems such as a stroke
(see below under
inappropriate clotting).
http://www.residentnet.com/private/clot.htmhttp://www.residentnet.com/private/clot.htm -
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Clot retraction:
"tightening" of clot
contraction of platelets trappedwithin clot shrinks fibrin meshwork,
pulling edges of damaged vessel
closer together
Over time (with the amount oftime depending on the amount of
damage), the clot is dissolved and
replaced with normal tissue
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GOLONGAN DARAH
Membran sel darah manusia mengandungbermacam macam antigen golongan darahatau yang sering disebut aglutinogen
Yang paling penting dan yang paling dikenaladalah antigen A dan B
Antibodi terhadap aglutinogen sel darahmerah disebut aglutinin
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SISTEM ABO Antigen A dan B diturunkan secara dominan
Dibagi menjadi 4 golongan darah utama yaitu:- golongan Amemp. Antigen A dan mengembangkanaglutinin-B
- golongan Bmemp. Antigen B dan mengembangkanaglutinin-A
- golongan ABmemp. Kedua antigen dan tidakmengembangkan kedua aglutinin (merupakan universalrecipientdapat menerima darah dari siapa saja)
- golongan Otidak memp. Kedua antigen danmengembangkan kedua aglutinin (merupakan universal
donor
dapatmemberikan darah kepada siapa saja)
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SISTEM Rh
Selain antigen dari sistem ABO ada jugaantigen dari sistem Rh
Seseorang yang memiliki antigen Rh disebut
sebagai Rh+ Seseorang yang tidak memiliki antigen Rh
disebut sebagai Rh-
Antibodi terhadap antigen Rh(aglutinin) tidakdibawa dari lahir
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Blood Groups - Typing
Blood is typed into groups depending upon thetype of agglutinogens (antigens) present onthe red blood cell surface
The plasma may contain geneticallydetermined agglutinins or antibodies againstthe blood group antigens that they DO NOThave
The ABO and Rh system are based uponantigen-antibody type responses
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Blood Typing
people who posses the A antigen on the RBC surface are type A;
if you posses the B antigen you are blood type B;
if both A and B are present you are type AB;
if neither A or B antigens are present, your blood type is O
Type O - un iversal donor,can give blood to anyone
Type AB - un iversal recipient, can receive blood fromany blood type
ABO system -
Rh system
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Rh system individuals whose red blood cells possess the Rh
antigen are Rh+ (Approx 85%)
Antibodies against Rh antigens are not present
at birth but are stimulated by exposure
Hemolytic Disease of the Newborn
Only in Rh- mothers and an Rh+ child, after
exposure.
RhoGam -medication given to prevent
sensitization of Rh- mother